Objective

To determine the extent of implementation of the eight recommendations included in our initial audit report, Case Management (Report 2021-N-9).

About the Program

The New York City Department for the Aging (DFTA) promotes, administers, and coordinates the development and provision of services for older New Yorkers to help them maintain their independence and participation in their communities. According to the most currently available United States Census American Community Survey data, there were over 1.9 million adults age 60 and older (seniors) residing in New York City in 2023. DFTA contracts with community-based organizations (providers) to provide case management services, which help older persons with functional impairments gain access to appropriate services, benefits, and entitlements needed to age safely at home and maintain their quality of life. DFTA reported that more than 31,000 seniors received over 515,000 hours of case management services in City fiscal year ended June 30, 2024. For City fiscal year ended June 30, 2025, DFTA contracted with 20 providers servicing 21 case management program contracts, totaling over $48 million. As of City fiscal year 2025, case management providers are reimbursed based on a rate for each unit (hour) of case management service, not to exceed an approved budget. Furthermore, case management providers must adhere to DFTA’s Case Management Standards of Operations and Scope of Services (Standards), which detail when intake assessments and reassessments must be performed, as well as wait list prioritization. According to DFTA officials, as of February 2025, there were 338 people on the case management and 475 on the home care wait lists.

Our initial audit report, issued on July 26, 2023, examined whether DFTA provided and paid case management services appropriately for eligible seniors. The audit, which covered the period from January 2019 through October 2022, found that DFTA did not provide adequate oversight of its case management program. Specifically, the audit found that DFTA did not ensure that its contracted providers adhered to DFTA’s Standards; therefore, key milestones for delivering and monitoring services needed for vulnerable seniors were not always met. Clients spent significant time on waitlists before they could receive critical services, such as case management and home care. When services became available, a referral was not always prioritized such that those with the greatest needs received services first. Additionally, DFTA reimbursed providers for $10,480 in claimed expenses that had insufficient supporting documentation or were unrelated to the case management program. DFTA’s oversight of its case management providers was inadequate as it did not maximize the use of available case management data, and it did not include certain aspects of case management in its evaluations. DFTA officials also did not always review supporting documentation for personal service and other than personal service expenses prior to payment.

The objective of our follow-up was to assess the extent of implementation, as of May 12, 2025, of the eight recommendations included in our initial report.

Key Findings

DFTA has made some progress in addressing the problems identified in our initial audit report. Of the initial report’s eight audit recommendations, one was implemented, four were partially implemented, and three were not implemented.

Key Recommendation

DFTA officials are requested, but not required, to provide information about any actions planned to address the unresolved issues discussed in this follow-up within 30 days of the report’s issuance.